静脉应用银杏叶制剂治疗急性缺血性卒中有效性和安全性的meta分析  

Meta-Analysis of the Efficacy and Safety of Intravenous Ginkgo Biloba Leaf Preparation in the Treatment of Acute Ischemic Stroke

作　　者：胡燕琴[1] 赵陶丽[1] 李申 郭东兴 赵志刚[1] HU Yanqin;ZHAO Taoli;LI Shen;GUO Dongxing;ZHAO Zhigang(Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Community Health Service Center,Beijing Jiaotong University,Beijing 100091,China)

机构地区：[1]首都医科大学附属北京天坛医院药学部,北京100070 [2]北京交通大学社区卫生服务中心

出　　处：《中国卒中杂志》2025年第4期462-469,共8页Chinese Journal of Stroke

摘　　要：目的系统评价静脉应用银杏叶制剂治疗急性缺血性卒中(acute ischemic stroke,AIS)的有效性和安全性。方法计算机检索PubMed、Embase、Cochrane Library等英文数据库,以及万方、中国知网、维普等中文数据库,分析银杏叶制剂静脉注射治疗AIS的随机对照试验,检索时限为建库至2024年7月30日。使用Cochrane RevMan偏倚风险评估表评价纳入研究的质量。使用RevMan 5.3软件,对银杏叶制剂治疗AIS的预后、早期神经功能改善、神经功能缺损、总有效率、不良反应等指标进行meta分析。结果本研究共纳入9篇文献,其中英文文献3篇,中文文献6篇,共6111例患者,其中对照组3103例,试验组3008例。meta分析结果显示,静脉应用银杏叶制剂可提高AIS患者的预后良好(mRS评分≤2分)率(OR 1.95,95%CI 1.72~2.22,P<0.001),降低mRS评分[标准化均数差(standardized m ean difference,SMD)-0.67,95%CI-0.76~-0.58,P<0.001],提高患者的早期神经功能改善率(OR 1.23,95%CI 1.07~1.41,P=0.003),降低患者的NIHSS评分(SMD-1.36,95%CI-1.54~-1.17,P<0.001)。另外,静脉应用银杏叶制剂可以提高AIS治疗的总有效率(OR 3.68,95%CI 1.81~7.49,P<0.001),且不增加不良反应的发生率(OR 1.01,95%CI 0.85~1.20,P=0.870)。结论静脉应用银杏叶制剂对AIS具有脑细胞保护作用,可改善患者的预后,且不增加不良反应。Objective To systematically evaluate the efficacy and safety of intravenous ginkgo biloba leaf preparation in the treatment of acute ischemic stroke(AIS).Methods Randomized controlled trials of intravenous ginkgo biloba leaf preparation in the treatment of AIS in English databases such as PubMed,Embase,and Cochrane Library,as well as in Chinese databases like Wanfang,CNKI,and VIP were searched by computer.The search period was from the establishment of these databases to July 30,2024.The quality of the included literature was evaluated using the Cochrane RevMan bias risk assessment table.Using RevMan 5.3 software,a meta-analysis was performed on prognosis,early neurological improvement,neurological deficits,total effective rate,adverse reactions,and other indicators of ginkgo biloba leaf preparation in the treatment of AIS.Results A total of 9 articles were included in this study,including 3 in English and 6 in Chinese,which involved 6111 patients,comprising 3103 in the control group and 3008 in the experimental group.The meta-analysis results showed that intravenous ginkgo biloba leaf preparation could improve the rate of good prognosis(mRS score≤2 points)of AIS patients(OR 1.95,95%CI 1.72-2.22,P<0.001),reduce the mRS score[standardized mean difference(SMD)-0.67,95%CI-0.76--0.58,P<0.001],enhance the rate of early neurological improvement of patients(OR 1.23,95%CI 1.07-1.41,P=0.003),and decrease the NIHSS score of patients(SMD-1.36,95%CI-1.54--1.17,P<0.001).Ginkgo biloba leaf preparation could improve the total effective rate of AIS treatment(OR 3.68,95%CI 1.81-7.49,P<0.001),without increasing the incidence of adverse reactions(OR 1.01,95%CI 0.85-1.20,P=0.870).Conclusions Intravenous ginkgo biloba leaf preparation has a brain cytoprotection effect on AIS and can improve the prognosis of patients without increasing adverse reactions.

关 键 词：急性缺血性卒中 银杏叶提取物 神经功能 预后 不良反应 

分 类 号：R74[医药卫生—神经病学与精神病学]